What are mouth ulcers a sign of?


New Delhi:  A large number of conditions leads to the formation of ulceration in the oral cavity. Identification of duration, course, pattern, location of ulcer/ulcers is important as it differs in their pattern of occurrence in a various diseases. Aphthous ulcer or canker sore is one of the most common ulcerative condition occurring in the mouth. 20 % of the world population will be affected by it at some point in their life. It frequently has an impact on daily life interfering with the routine activities like eating, swallowing and speaking. It can occur on lips, cheeks, floor of the mouth, the tip or ventral surface of the tongue, soft palate, and the tonsillar areas. These ulcers present as recurrent, multiple, small, round, or ovoid ulcers, with regular margins, having yellow or  gray floors and are surrounded by reddish areas, present first in childhood or adolescence. They can be minor (<1 cm) or major (>1 cm) depending on their size and the duration for which it is present. Minor ulcers heal in 4-14 days while major ulcers can last for up to 30 days and heal with scar formation. It is considered as a multifactorial disease with the several factors being accused in the etiology of the disease. It may be related to intrinsic factors like increased prevalence in females owing to hormones, familial tendency of developing ulcers, nutritional deficiency of iron, zinc, folic acid & vitamins like B1, B2, B6, B12, Vit C & Vit A or extrinsic factors like tobacco, stress, local causes like trauma, anesthetic injections, tooth brushing & dental treatment, hypersensitivity to certain foods & drugs. Treatment options are mainly palliative in nature which includes multivitamin therapy, steroids, immune-modulators & topical analgesic agents, unless a more serious systemic condition is co-occurring. The goals of therapy are to decrease pain and ulcer size, promote healing, and decrease the frequency of recurrence. In cases of non-resolving ulcers, a referral to a medical doctor is indicated, since it could be the first sign of a more serious health condition. Dr. Nandika Dubey BDS, MDS Oral Physician & Maxillofacial Radiologist